Abstract B30: Patient navigation for cervical cancer in Kentucky: Baseline results

Background: Although morbidity and mortality rates are low compared to other types of cancer, cervical cancer remains a high priority for the following reasons: 1) invasive cervical cancer is a disease that could be prevented in nearly all cases, with greater use of the Pap test; 2) the Pap test is a well‐established, low cost, widely available screening test that should present minimal barriers to its use; and 3) despite our ability to prevent and treat cervical cancer, the burden of cervical cancer morbidity and mortality continues to be higher among low‐income women with limited education, many of whom reside in rural areas. Despite public health recommendations for cervical cancer screening and follow‐up of abnormal Pap test results, adherence is still low among rural Appalachian women in Kentucky. In response to this concern, the University of Kentucky Prevention Research Center is implementing a National Cancer Institute‐funded project that is integrating patient navigators (PN) in cervical cancer screening programs in several rural health departments. Goal: To reduce the disproportionate burden of cervical cancer experienced by rural Appalachian women in Kentucky. Objectives: To: 1) improve our understanding of the barriers to follow‐up; 2) recruit, train, and utilize lay health workers as PNs in cervical cancer screening programs; 3) increase the proportion of women who adhere to recommended follow‐up; and 4) evaluate the efficacy of the intervention. Method: Intervention activities are as follows: 1) nurse case managers refer patients with abnormal pap tests to PNs in selected local health departments in Big Sandy, Lake Cumberland, and Kentucky River Area Development Districts; 2) PNs enroll patients in the study; 3) study participants complete a baseline interview; 4) PNs provide navigation services including outreach, education, and support; 5) PNs conduct follow‐up interviews; and 6) PNs document follow‐up recommendations, barriers, patient needs, and specific actions taken to ensure adherence to follow‐up recommendations. Evaluation: To assess the efficacy of the intervention, outcome data will be collected from health department records in intervention and control counties. Findings: The total number of referrals to date is 600. Among the referrals: 82 (14%) were ineligible (patient less than 18 years, refused services, dropped by health department for non‐compliance, or lost to follow‐up); 379 (63%) were offered enrollment; and enrollment is pending for 139 (23%). Among those offered enrollment, 297 (78%) agreed to participate in the study. Additional preliminary findings will be presented including reason for referral, characteristics of women enrolled, patient needs, adherence to follow‐up, etc. Conclusions: The program creates a unique opportunity to support rural cervical cancer screening programs, ensuring women obtain their recommended follow‐up care through the support of PNs. Citation Information: Cancer Prev Res 2010;3(1 Suppl):B30.